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Fitness Forum

Mar 01, 2008

Fitness Forum

Your feedback, concerns and insights.

Digital IDEA Fitness Journal Feedback

I noticed your article on medical fitness (December digital IDEA Fitness Journal) in the “best of” list. You did an excellent job, and I still believe that it is the wave of the future. Years ago, medical nutrition was not part of medical school, but now it is. We are now offering a specialty qualification in nutrition and exercise for our medical students, after a number of them completed internships with me last summer. Recently I spoke to our residents at the [Veterans Administration] hospital and, although they are hospitalists, they enjoyed hearing about articles from [The Journal of the American Medical Association] on physical activity and health, and we exercised using a “fit it in” approach—so it was fun. Next, I’ll speak to our primary care doctors, as I think they’ll have the greatest impact. The sticking point is billing, since fitness professionals are not licensed—and there is concern over who is qualified and what that entails. There are lots of barriers to overcome, but with ACSM’s Exercise as Medicine and IDEA’s [and other group’s] promotions, hopefully the field will emerge.

Mary E. Sanders, PhD, FACSM
Associate Professor, Division of Medical Nutrition
University of Nevada, Reno

I have just finished reading the article “Going From Foodie to RD” (December digital IDEA Fitness Journal). The article was very informative about how a fitness expert could further her career with education to become a [Registered Di­etitian (RD) Technologist] or an RD. A huge gap exists between the degreed nutrition professional and the general population requiring services, and the nutrition science industry has yet to address this growing need.

From a grass-roots level, we see new businesses addressing obesity issues and the publishing industry advancing new books that essentially rehash the basic food principles. As personal trainers, we seek to augment our education to enhance our services to our clientele and remain personal trainers. It’s foolish to suggest we require a 4-year degree to achieve that. The stringent qualifications of the RD are comparable to those for physical therapists. Yet within the fitness area we have exercise science—and those graduates are strongly encouraged to become certified by the same certifying bodies that the nondegreed have access to. Over the past 25 years, a fledging concept has developed into a billion-dollar industry with our own high standards. If nutrition certifications aren’t acceptable to the nutrition industry, how is that being addressed?

Fitness and nutrition go hand-in-hand toward good health. Personal trainers cannot ignore nutrition, as it is the fuel source for activity. Conversely, nutritionists could ignore the fitness aspect (although we hope they would not!).

Our obesity epidemic grows. Our national hunger for sensible, solid nutrition advice grows. The fitness and nutrition industries need to jointly address the lack of acceptable certifications and lack of personnel who can deliver services, professionally and within the scope of practice, to the general population.

Becki Bottoms
Carmel, Indiana

Diabetic Clients

I am so grateful for the article “Working With Diabetic Clients” (November–December, page 54). I have my first “confessed” diabetic client, and this article is just what I need. Sometimes clients don’t let you know up-front about this medical issue—even when you’ve tried to do a thorough check on their personal needs assessment. I now keep little apple juice boxes handy just in case some [clients] are less than forthcoming. Thank you!

Sarah Booker
Santa Maria, California

Certification? Licensure? What’s on PFTs’ Minds?

I read the article “Certification Standards? Licensure? What’s on People’s Minds?” in the January issue (p. 51), and I think the points raised are extremely pertinent and crucial to our longevity and integrity as fitness professionals. As a small-business owner who focuses on cardiovascular risk-factor modification and chronic disease management, I must say that a measurable and attainable standard for our profession is needed in the very near future. As you know, we are embarking on a time in our communities during which our clients are getting older, more health conscious and more likely to need some type of risk-factor management strategies built into their training programs. Whether it is hypertension, diabetes or more serious medical concerns, personal trainers over the next 10 years must become equipped to deal with such issues.

I sit on a national personal trainer certification committee, which recently met for our semiannual meeting. Issues related to industry standards and certification credentials were a very “hot” topic. I think it is up to very visible and credible organizations such as IDEA and ACSM to set the standards and lead the exercise and fitness industry into the next phase. Gone are the days when personal trainers should be musclebound power lifters; instead, they should be health-conscious fitness experts. More people are seeking the advice of companies like mine for strategies to make a difference in their health profile, rather than their repetition maximum on a bench press.

What is the next step? Restricting the number of NCCA-accredited agencies for certified personal trainers (CPTs) will be a start because as more become NCCA-accredited, the more diluted the standard for CPTs becomes, which puts us back in the same predicament as [we were in] before accreditation in our industry began. A CPT license accessible to professionals with certain credentials would be a huge step for our industry. We need to find a way to maintain and develop industry standards that everybody must adhere to in order to call themselves personal fitness trainers, or any variation thereof.

I have four specific roles in the industry: I am an exercise physiologist in a clinical rehabilitation setting; I am a certified personal trainer with a limited number of clients; I am a small-business owner/
manager with six trainers to keep busy; and I am an exercise science instructor at a local college. I see students with no experience and I work with very seasoned professionals. I think there is more need now than ever to address these issues from several aspects, including those that I am directly involved with.

Thank you for your time and dedication to our careers!

Tom Spring, MS, CES, CPT
Huntington Woods, Michigan

I’ve been through some pretty nasty wrangles with club owners who didn’t see the harm in misleading their members about their staff’s certifications. I most definitely agree there ought to be more stringent guidelines in place than a weekend workshop coupled with “I’ve-worked-out-for-years-so-I-know-what-to-do” experience. I still cringe at what I see going on in gyms that I visit, and I find myself wondering if the staff truly carries the credentials claimed. Unfortunately, most of the public simply don’t consider that when choosing their instructor/trainer.

As wellness professionals, we should be more concerned about the whole package during assessments and not just how lean and mean we can get [clients] in as little time as possible. With more stringent education/practical experience/qualifications in place, that would likely weed out the “work ’em till they puke, mirror-muscle trainers” so many flock to.

It would also be beneficial to have some protection in place for those unfortunates who blow the whistle on unscrupulous owners. In Washington State, none is offered unless [the whistleblower] works for the state or the medical profession. Harassment and discrimination can be carried out with impunity unless you have oodles of money to file a lawsuit within the court systems.

I agree with the experts who voiced their opinions in the certification and licensure article. People put their wellness in our hands, and we should be held to some pretty high standards so that the flashiest drill sergeants in the industry aren’t the gold standard that the easily seduced are drawn to.

Nancy L. Jerominski
SeaTac, Washington

Teen Girls and Yoga

As a mother of a teenage daughter and a yoga practitioner for the past two decades, I loved Beverly Blair Harzog’s article “Image Conscious: Why Teenage Girls Need Yoga” (January, page 92). From an early age, girls are bombarded with unrealistic media images and poor Hollywood role models. In addition, the competitive environment of sports, school and social situations can create additional stress. Along with an international communications expert, I have been leading Mother and Daughter Yoga Retreats to help girls learn how to create positive and healthy thoughts and emotions and release feelings of judgment, criticism and competitiveness through yoga. Study after study proves that a healthy relationship between mothers and daughters leads to both the mother and daughter enjoying increased happiness, success and longevity.

Stacy McCarthy, RYT
Rancho Santa Fe, California

Study Design on Low-Fat Dairy Consumption Flawed?

I really appreciate your sending me a copy of the September issue with our whey advertorial. However, I was disappointed to look further into the journal and see a piece on a study by J.E. Chavarro and others published in [the May 2007 issue of] Human Reproduction and titled, “A Prospective Study of Dairy Foods Intake and Anovulatory Infertility.” The high­­light of your report, titled “Get milk? Get pregnant?” [Food for Thought, p. 79] sum­marized [Chavarro’s] findings, which concluded that consuming high-fat dairy foods decreased the risk of anovulatory infertility, and consuming low-fat dairy foods increased its risk. While we understand the importance of IDEA to communicate current research findings and their implications to the public, we would like to bring to light several critical weaknesses of this study and emphasize the potential negative implication this study may have on nutrient intake among women, a population that already consumes significantly lower amounts of recommended nutrients such as calcium that are found in dairy foods.

The Chavarro study evaluated the association between dairy foods and anovulatory infertility in over 18,000 women and found that the fat content of the dairy foods determined women’s risk for the infertility. While the researchers controlled for several factors that may influence infertility (including age, exercise and smoking), they failed to control for other factors (including socio­economic status) and dietary patterns (including total fat and energy­ intake) that may have influenced the results. The authors themselves state that after adjustments for other variables, “. . . only dairy fat intake was associated with a lower risk of anovulatory infertility. The intakes of lactose and phosphorus were not associated with anovulatory infertility in any of the models.”

Since most dairy foods contain lactose and phosphorus, and lactose particularly is a direct indicator of dairy food intake, this study essentially concludes that there is no association between dairy food consumption and anovulatory infertility. The only association found between anovulatory infertility and dairy foods resulted from the fat content of dairy foods. Because total calories, total fat intake and total nutrient intake were not accounted for in this study, it could very well be hypothesized that women consuming high-fat dairy foods may also consume significantly different amounts of calories, fat and/or nutrients compared with the low-fat dairy food consuming group. One or more of these variables may actually be accountable for the observed differences in fertility.

Last, the authors of the study admit that very little research had been conducted to determine the effect of dairy foods on fertility, and the results of those studies have been directly contradictory.

On a final note, this study was purely observational and did not measure any type of cause and effect regarding anovulatory infertility. Therefore, the conclusions and implications of the study need to be determined extremely cautiously. Unfortunately, highlighting a study that is purely observational and does not account for critical variables may be interpreted falsely by the general population and in this case may have a negative effect on essential nutrient intake for women. The IDEA summary piece does acknowledge the contradictory data available on the subject and reminds women that the current study is not an endorsement for whole milk for those wishing to become pregnant. Unfortunately, the summary piece does not remind its consumers of the 2005 Dietary Guidelines recommendations encouraging individuals to consume three servings of low-fat and fat-free milk or milk-equivalent products since these foods provide three of the five “nutrients of concern” for Americans: calcium, potassium and magnesium. Reiterating to consumers the importance of consuming adequate levels of foods and nutrients, as recommended by the science-based 2005 Dietary Guidelines and other leading health professionals, for overall health is critical, particularly if the results of observational, highly inconclusive research are to be reported.

Marlene Schmidt, MS, RD
Vice President, Nutrition Affairs
National Dairy Council
Rosemont, Illinois

Next Stop: Mount Everest!

Thank you for covering the story about my quest to Inspire the World to Fitness® [by climbing the world’s highest mountains]. (See “Seeking the Summit,” January, page 24.). I am so proud to be a part of such a wonderful organization, which I feel has brought so much to my professional life. I will always continue to do my best to Inspire the World to Fitness.

Nancy Norris
Grand Blanc, Michigan

Fitness Journal, Volume 5, Issue 3

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